DIET, OBESITY AND WEIGHT CHANGE IN PREGNANCY

怀孕期间的饮食、肥胖和体重变化

基本信息

批准号：
9467405
负责人：
MYLES FAITH
金额：
$ 19.26万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-03-27 至 2018-09-26
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9467405
关键词：
Address Adherence Age Alcohol abuse Appetite Regulation Basic Science Behavioral Blood Body Composition Body Image Body Weight Body Weight Changes Body mass index Brain C-reactive protein Carotenoids Categories Characteristics Child Chronic Chronic Disease Clinic Collection Consumption Data Diet Dietary Assessment Dietary intake Discipline of obstetrics Disinhibition Drug abuse Eating Eating Behavior Eating Disorders Elements Eligibility Determination Energy Intake Enrollment Environmental Risk Factor Fasting Fatty acid glycerol esters Feces First Pregnancy Trimester Focus Groups Food Food Preferences Food Processing Frequencies General Population Genetic Gestational Diabetes Guidelines Gynecology Hair Health Health Status Health behavior Hour Hydrocortisone Hyperphagia Hypertension Illicit Drugs Impulsivity Individual Infant Infant Food Informed Consent Institute of Medicine (U.S.)Insulin Intake Interleukin-6 Intervention Studies Laboratories Link Lipids Maternal and Child Health Measures Mental disorders Mothers National Institute of Child Health and Human Development Nausea Neurologic Neurosciences Nutritional Obesity Observational Study Outcome Outcome Measure Overweight Palate Participant Perception Perinatal Phenotype Physical activity Placenta Population Population Research Postpartum Period Predisposition Pregnancy Pregnant Women Prevalence Procedures Protocols documentation Psychological reinforcement Public Health Questionnaires Randomized Recording of previous events Recruitment Activity Reproductive History Research Rewards Risk Role Saliva Sampling Satiation Self-Administered Self-control as a personality trait Ships Sleep Sodium Source Specimen Stress Substance abuse problem System TNF gene Taste Perception Testing Time Umbilical Cord Blood United States Urine Weight Weight Gain Woman adiponectin base biobank clinical development craving discount discounting drug of abuse eating in absence of hunger emotional eating experience experimental study fasting glucose food environment genetic variant gestational weight gain health economics hedonic innovation non-smoking pregnant primary outcome prospective public health intervention racial and ethnic reproductive response restraint sugar weight loss intervention

项目摘要

The rising prevalence of obesity in the U.S. over the past several decades and the accompanying spread of adverse long-ranging health effects pose serious public health and economic consequences. While a genetic contribution to obesity is well-established, genetic factors underlying individual susceptibility to common obesity have modest effects, which can be amplified considerably in the presence of certain triggering environmental factors. Approximately two-thirds of women of reproductive age now enter pregnancy at a high body mass index, and the majority of women experience pregnancy-associated weight gains in excess of Institute of Medicine guidelines, leading to increased perinatal and chronic health risks for both mother and child. The increased prevalence of obesity among women of reproductive age is reflected in a concomitant increase in the prevalence of gestational diabetes (GDM), which confers additional increased risk of adverse maternal and child health outcomes. Limited previous intervention research has indicated modest improvement in short-term maternal diet and gestational weight gain, with little evidence of long-term adherence. The well-documented inadequacies of these and traditional weight-loss interventions relying on existing health behavior paradigms suggest the need for innovations that allow for a shift in the theoretical framework underlying the determinants of eating behavior. Recent findings from basic research in neuroscience suggest that the brain reward response to highly palatable foods is a critical element that is currently absent in current theoretical frameworks. Individuals vary with respect to their �food reward responsivity�, which refers to susceptibility to the effects of food and eating on the brain reward system. Simultaneously, foods vary with respect to their �reinforcement value�, which refers to the degree to which foods activate the brain reward system. Whereas certain foods elicit a normative food reward response that is sensitive to homeostatic regulation of appetite, it is hypothesized that �hyperpalatable� foods, which elicit exceptionally pronounced activation of the brain reward system, may blunt this sensitivity, leading to hedonic, non-homeostatic overeating characterized by food intake beyond energetic needs. Repeated consumption of hyperpalatable foods reinforces the brain food reward response and culminates in neurological changes similar to those observed with drugs of abuse. However, this rapidly-expanding body of work has not yet been incorporated into population-based research. Research to date on food reward responsivity and food reinforcement value has been conducted primarily in small samples in the general population. However, to date, no studies have examined these constructs among pregnant women. While it is known that most women gain more weight than recommended and many do not return to their pre-pregnancy weight, there is insufficient data on individual determinants of dietary intake and weight change during and after pregnancy. Understanding the association of food reward responsivity and food reinforcement value with dietary intake and weight change during pregnancy and postpartum may be informative for the development of clinical and public health interventions that promote optimal diet and weight in this population.

美国严重性数十年来的肥胖症的发生率上升，而不利的健康爱好伊斯兰教帝国的脓液和经济后果的差异则伴随着。这可能会在高体重指数上怀孕，这可能是生殖年龄的妇女，大多数妇女经历了与医学研究所指南相关的怀孕相关体重增加，从而导致母亲和儿童的围产期和慢性健康风险增加。肥胖的妇女反映了妇女糖尿病（GDM）伴随着AD儿童健康饮食和妊娠体重增加的风险的增加关于Existh行为的范例，允许在理论框架中转移饮食行为的决定因素。大脑奖励的食物是指大脑奖励的程度。以食物为特征。在一般人群中的小样本中。食物的供应和食物增强价值与饮食摄入量和产后的变化有关，可能是临床和公共卫生干预措施的发展，这些干预措施可以促进该人群中最佳的饮食和体重。